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General NPI Number Information
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NPI Number | 1710381827
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Entity Type | Organization
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Legal Business Name | MJKNIGHT ENTERPRISE LLC
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Dates
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Enumeration Date | 10/17/2014
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Last Update Date | 02/05/2015
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Provider Practice Location Address
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Address Line | 5411 S HOYNE AVE
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City | CHICAGO
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State | IL
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Zip | 60609-5548
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Country | US
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Telephone | 773-750-0832
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Fax | 773-897-5827
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Provider Business Mailing Address
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Address Line | 5411 S HOYNE AVE
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City | CHICAGO
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State | IL
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Zip | 60609-5548
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Country | US
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Telephone | 773-750-0832
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Fax | 773-897-5827
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. MONIQUE JONNEL MCKNIGHT
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Credential |
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Telephone | 773-750-0832
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | 04986016
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License Number State | IL
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